CENTRAL NEW JERSEY AFFILIATE SPRING 2003 VOL. 5 NO. 1 OCF OBSESSIVE COMPULSIVE FOUNDATION Newsletter Every Meeting is a Learning Experience December Quarterly Meeting: Dr. Karen Landsman to One of Our Best Ever! Speak at Next Quarterly Meeting On December 9, 2002, we had our most 2. Hoarding recent quarterly meeting. It took place 3. Contamination, washing and cleaning The next quarterly meeting of the NJ in our new venue at Robert Wood Affiliate is on Monday, March 10, at 7 Johnson Hospital, in New Brunswick. 4. Aggressive obsessions and check- ing PM. It will again take place at our new The new room was bright, very large, venue, Robert Wood Johnson Hospital- (the room easily holds 80 people com- 5. Morality, scrupulosity, and issues of blasphemy see accompanying article for specific fortably), and the chairs were unusually directions. comfortable! The only complaint was Brain Biology of OCD. Next, Dr. that the parking in the parking deck was Dr. Landsman received her Ph.D. in a little crowded, so be sure that for next Page discussed the specific brain mechanisms believed to be involved in clinical psychology from the University meeting you give yourselves a few extra of Maryland at College Park. She minutes to navigate the parking deck! OCD. She starts this part of her pres- entation by commenting that it is not received specialized training in cogni- tive-behavioral treatment with Dr. Alan But the new venue wasn’t the best part so much the size of the human brain that differentiates it from other ani- Bellack during her internship and a of the evening. We were honored to post-doctoral fellowship at the have Dr. Jessica Page come in from mals’, but rather the incredible number of neural interconnections between its University of Maryland School of New York City to talk with us about the Medicine. She continued her clinical neurobiology of OCD and about some parts. It is these connections between certain parts of the brain that seem to training with Dr. Jonathan Grayson at of the ground-breaking research that she The Anxiety and Agoraphobia is involved in. be involved in the development and expression of OCD. She then went on Treatment Center in Philadelphia. Dr. to describe the three specific brain Landsman specializes in the treatment Dr. Page, a clinical psychologist at the of children, adolescents, and adults with New York State Psychiatric Institute structures believed to be at the heart of the experience of OCD. OCD and other anxiety disorders. She and Columbia University, is the site currently has an independent practice in director of an NIMH-funded genetic Westfield and Chatham, New Jersey. study of Obsessive Compulsive Frontal Cortex. Located at the front of Disorder. This is a national research the brain, right behind the forehead, this is the part of the brain involved in Dr. Landsman's topic will be, project that also involves sites at Johns "Encouraging Risk-Taking in OCD Hopkins University, Columbia "executive functioning" of the brain. This includes complex problem solv- Treatment." Exposure and response University, Brown University, UCLA prevention treatment requires taking and Harvard University. She and her ing, planning, and thinking about the future. It is the area of the brain that risks, and family members of those suf- colleagues across the country are at the fering from OCD can play an essential forefront of genetic research on OCD. allows us to organize and plan behav- ior. role in encouraging risk-taking. This presentation will help family members Subtypes of OCD. Dr Page began by identify ways that they can effectively reporting that much of the research Basal Ganglia. In particular, the Caudate Nucleus, which is seen support their spouse, child, or other results in OCD is inconclusive, because family member undergoing treatment while certain interventions (specifically, through PET scans as actually being smaller in OCD afflicted individuals. for OCD. Please come to listen to what medications) work well with OCD in will no doubt be a stimulating presenta- some studies, in other studies the results This part of the brain is involved in automatic motor functions. When tion, to have some refreshments, and to are not as clear. She suggested that one shmooze! explanation is that OCD is really made brain damage occurs at this section of up of different subtypes, each subtype the brain, it results in repetitive, non- having its own differential response to sensical movements or tics. certain medications. These subtypes are NEXT MEETING AT divided up into groups of symptoms and The Limbic System. Located at the NEW LOCATION! are presently viewed as the following: base of the brain, it is a much more SEE INSIDE FOR 1. Symmetry, repeating, counting and continued on page 3 ordering behaviors DIRECTIONS! PRESIDENT’S MESSAGE NATIONAL OCD FOUNDATION CONTACTS OCF Phone: (203) 315-2190 It gives our Affiliate great pleasure to welcome Dr. PO Box 9573 Fax: (203) 315-2196 Rita Roslyn Newman to our Advisory Board. She New Haven, CT 06535 brings along a wealth of knowledge regarding medications for the treatment of Obsessive- E-mail: [email protected] Compulsive Disorder. Internet: www.ocfoundation.org Dr. Rita Roslyn Newman $$$$$$$$$$$$$$$$$$$$$$$$ Dr. Newman has maintained a psy- YOU CAN HELP... chiatric practice in Short Hills, New With production cost and postage rates climbing and our Jersey for more than twenty years. A mailing list growing rapidly, we would like to mention that full attending physician at Saint any voluntary contribution would aid us to keep this NJ Barnabas Medical Center in Affiliate Newsletter going. Livingston, New Jersey, she is Past - Board of Directors President of both the Tri-County Chapter of the New Jersey $$$$$$$$$$$$$$$$$$$$$$$$ Psychiatric Association and the New Jersey Medical Women’s Associatinon, and served for years as Chair of the Any Comments????? Mental Health Committee of the Essex County Medical Society. The staff of the Newsletter encourages all comments on our published articles. Also, any letters and articles, which you A Life Fellow of the American Psychiatric Association, she wish to submit for our quarterly publications, are welcome. chairs the Human Rights Committee of the Association of Please submit them to, Ina Spero, NJ OCF, 60 MacAfee Women Psychiatrists and has been a member of the Road, Somerset, NJ 08873. Committee Against International Abuse of Psychiatry of the American Psychiatric Association. Dr. Newman has been Disclaimer Psychiatric Consultant to the New Jersey Holocaust The information in this Newsletter should not be taken in Commission since 1980. She has served on the Victimology lieu of proper medical and/or mental health professional Committee of the American Academy of Psychiatry and the services. The Board of Directors of the New Jersey Affiliate Law and the Bio-Ethics Committee of Saint Barnabas of the Obsessive Compulsion Foundation, as well as all other Medical Center, Livingston, New Jersey. volunteers involved in the development and distribution of this Newsletter, do not endorse any particular viewpoint or For many years, Dr. Newman has conducted workshops, information presented here. Again, nothing takes the place courses, and seminars at national meetings and international of proper medical/mental health professional services. congresses on sexual harassment in the workplace, post-trau- matic stress disorder, and the well-being of Holocaust sur- NJAOCF MISSION vivors. The treatment of Obsessive-Compulsive Disorder and Psychopharmacology are an integral part of her expertise. The Affiliate is a community of those who have an interest in Obsessive Compulsive Disorder and whose goals are: ! 1) To educate the public and professional communities about the disorder. ! 2) To support individuals afflicted and their significant others. TENTH ANNUAL NATIONAL ! 3) To support research into the causes and treatments of OBSESSIVE-COMPULSIVE this disorder. FOUNDATION CONFERENCE NJAOCF OFFICERS Ina Spero - President NASHVILLE, TENNESSEE Dr. Allen Weg - Vice President, Newsletter Editor Jeanne Yarrow - Secretary Julian Spero - Treasurer JULY 25-27, 2003 Nicole Torella - Newsletter Editor Dr. Rita Roslyn Newman - Advisory Board member 2 December Quarterly Meeting: One of Our Best Ever! continued from front page primitive section, focusing on emotion and the experience of fear. Damage in this area results in the inability to block out behav- ioral responses to thoughts. These three systems are interconnected by neurotransmitter pathways. If the pathways are overactive, as is believed to be the case with OCD, then the results are an increase in goal-directed behavior and in mental planning. In OCD, the Limbic System experiences fear about safety, whether the door has been locked for example. The Cortex receives this message and responds, "What do I need to do to deal with this dilemma? I need to go check on the door!" The Basal Ganglia then sends the message that the body needs to move and go physically check the door. Brain Chemistry of OCD. Dr. Page then discussed the role that the neurotransmitters themselves play in the disorder. We know that SSRI medications (e.g., selective serotonin reuptake inhibitors, which include such medications as Prozac, Paxil, Zoloft, Luvox, Celexa, and to a certain degree Anafranil and Buspar), effect the availability of serotonin levels in the brain. While these medicines do help OCD sufferers, we also know they do not help all OCD sufferers, and do not effect all symptoms equally. So while serotonin plays a part in OCD it is not the end of the story. Serotonin seems to regulate other brain chemicals. There seems to be an inverse relationship between Serotonin and Dopamine, so that when one goes up, the other goes down. We also know that when Dopamine goes up, so does the level of physical activi- ty. Scans have actually indicated that the three brain areas described above are often saturated with these particular neurotransmit- ters in persons with OCD, seeming to further implicate their role in the disorder.